Sharbatkhori Mitra, Montazeri Mahbobeh, Besharat Sima, Fakhar Mahdi
Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Department of Parasitology and Mycology, School of Para-Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Ann Parasitol. 2022;68(4):667-672. doi: 10.17420/ap6804.473.
There are some doubts about the exact relationship between neglected infectious diseases (NIDs) and COVID-19 disease, which remains to be clearly defined. The present review summarized the effect of parasitic infections as the risk factors or protective agents in the COVID-19 pandemic. Parasites could proficiently modulate immune responses. Thus, parasitic infections could have a different impact on the incidence and clinical severity of COVID-19 in different regions of the world. Also, restoring programs to prevent, treat, and control NIDs, in particular helminths, could help in reducing the incidence and mortality of COVID-19 in endemic areas and help to increase vaccination effectiveness. Changes in the gut microbiome associated with helminth infection may have systemic immunomodulatory effects toward suppressing host immune responses, reducing vaccine efficacy and increasing the severity of other infectious diseases. The cytokine storm observed in severe cases of COVID-19 is characterized by a predominance of proinflammatory cytokines, such as IL-6. However, it is possible that helminth infection could change the outcome of infection by modifying the Th2 response to limit the inflammatory component; this would be particularly apparent in areas endemic for helminthic infections, which suggests a possible protective effect against COVID-19. Because parasitic infections affect more than 2 billion people throughout the world, their impact on COVID-19-associated effects on public health could be considerable. Further studies with larger sample sizes would be needed to explore the possible role of neglected parasitic infections in the COVID-19 pandemic.
关于被忽视的传染病（NIDs）与新冠肺炎之间的确切关系存在一些疑问，这仍有待明确界定。本综述总结了寄生虫感染作为新冠肺炎大流行中的风险因素或保护因素的作用。寄生虫能够有效地调节免疫反应。因此，寄生虫感染可能会对世界不同地区新冠肺炎的发病率和临床严重程度产生不同影响。此外，恢复预防、治疗和控制被忽视的传染病（尤其是蠕虫病）的项目，可能有助于降低流行地区新冠肺炎的发病率和死亡率，并有助于提高疫苗接种效果。与蠕虫感染相关的肠道微生物群变化可能会对宿主免疫反应产生系统性免疫调节作用，从而降低疫苗效力并增加其他传染病的严重程度。新冠肺炎重症病例中观察到的细胞因子风暴的特征是促炎细胞因子（如白细胞介素-6）占主导。然而，蠕虫感染有可能通过改变辅助性T细胞2型（Th2）反应来限制炎症成分，从而改变感染的结果；这在蠕虫感染流行地区可能尤为明显，这表明蠕虫感染对新冠肺炎可能具有保护作用。由于寄生虫感染在全球影响着超过20亿人，它们对与新冠肺炎相关的公共卫生影响可能相当大。需要开展更大样本量的进一步研究，以探索被忽视的寄生虫感染在新冠肺炎大流行中可能发挥的作用。
